Kennedy pledges to put patients first

The health service's inspector-in-waiting, Ian Kennedy, has vowed that the experience of patients will be at the heart of his organisation's work on assessing the performance of hospitals and other NHS organisations.

Outlining his vision for the proposed new NHS regulatory body, the commission for healthcare audit and inspection (chai), Sir Ian also promised to reduce the burden of inspection on the health service, by introducing a devolved self-assessment regime.

He said his aim was to ensure that the measure of an organisation's success, such as in the annual league table star ratings, was based on the quality of healthcare as seen from the patient's perspective - especially vulnerable patient groups such as children, older people, people with learning disabilities or mental illness, and people from areas of social deprivation.

"If the NHS can take care of the most vulnerable, then it is a good sign that it is performing well for everyone," he said.

Sir Ian's work as chairman of the public inquiry into children's heart surgery in Bristol had "seared onto his mind" the importance of ensuring that patients have a clear and seamless journey from start to finish of healthcare.

In many cases patients bounced confusingly around different parts of the care system. "I'd like to bring some coherence to that, " he said.

Speaking last night in Glasgow at the NHS Confederation annual conference, Sir Ian said chai's motto might be "improvement, improvement, improvement" - but this would not be empty rhetoric. "Our aim is to put patients at the centre. Improvement must be what patients regard as improvement."

The system of three-yearly inspections introduced by the exisiting regulator, the commission for health improvement (chi) would be replaced by a continuous assessment approach in which data would be supplied by health bodies to local arms of chai.

This would result in fewer inspection visits to hospitals and primary care trusts, although chai would make random unannounced inspections to ensure that the data supplied by organisations was truthful. Chai would retain its powers to investigate NHS bodies that appear to be failing.

A consultation document published by chai, setting out its future approach, makes it clear that the switch away from central regulation would not entail a more gentle regime.

"It could be imagined that a reduction in the scale and scope of visits is intended to signal a lighter or softer touch from chai. This would be a mistake. What we envisage is no less stringent a system of assessment . . . it will be a system based on rigour," Sir Ian said.

A constant complaint of NHS bodies is that they are submerged in a stream of apparently uncoordinated visits from various inspection and assessment bodies. The chai document says in future it will "seek to eliminate duplication of effort and thereby reduce the burden of regulation."

Sir Ian is the shadow chairman of chai, which will replace chi in April 2004, subject to the health and social care bill successfully passing through parliament.